580例脑脊髓液标本的病毒病原学检测

Detection of viral aetiology in cerebral spinal fluid samples from 580 clinical cases

目的 对 1990～ 1997年粤东地区 5所医院临床诊断为中枢神经系统 (CNS)感染和无名热 (FUO)等患者 5 80例脑脊髓液 (Csf)标本进行病毒病原学检测。方法 用Hep 2和BHK 2 1细胞进行病毒培养。结果 从 113例Csf中分离出 5种 2 1个型病毒病原 ,检出率为 19.5 %。患者感染的病毒型别分布及构成比分别为 :脊髓灰质炎 (Polio)病毒 11例 (0 .0 973) ,其中Ⅰ型 1例、Ⅱ型 8例和Ⅲ型 2例 ;柯萨奇 (Cox)病毒 5 4例 (0 .4779) ,其中A2 4型 11例、B1型 10例、B4型 2例和B5型 31例 ;埃可 (ECHO)病毒 15例 (0 .132 7) ,其中 2 4型 4例、7型 3例、12型 2例和 3、11、14、15、2 7、32型各1例 ;肠道病毒 (EV) 2 5例 (0 .2 2 13) ,其中 70型 14例和 71型 11例 ;腺病毒 (Adv) 8例 (0 .0 70 8) ,其中2、3型各 3例和 7型 2例。在连续 8年的观察中发现 ,1990～ 1993年检出率为 14.2 % ,1994～ 1997年上升为 2 6 .1%～ 2 2 .5 %。各年份间检出率经统计学 χ2 检验差异有显著性 (χ2 =9.791,P <0 .0 5 )。结论 中枢神经系统和无名热等疾病的病毒感染率呈上升趋势 。

Objective To investigate the viral aetiology in cerebral spinal fluid (Csf) from 580 cases of CNS infection or FUO in Yuedong district from 1990 to 1997. Methods Virus isolation were done with Hep 2 and BHK 21 cells. Results 21 virus types of 5 kinds of viruses were isolated from 113 samples ( 19.5 %). Clinically diagnosed diseases included viral encephalitis 17.8 % (43/242), intracranial infection 20.2 % (47/233), paralytic diseases 24.3 % (9/37), FUO 37.5 % (9/24), convulsion 16.0% (4/25), Guillain Barre syndrome 5.3 % (1/19). Virus infection included 11 cases of Poliovirus (constitutional ratio 0.097 3 ,including 1 Polio Ⅰ,8 Polio Ⅱ,2 Polio Ⅲ); 54 cases of Coxsackie virus ( 0.477 9 ,including 11 CoxA24, 10 CoxB1,2 CoxB4, 3 CoxB5); 15 cases of ECHO virus ( 0.132 7 ,including 4 ECHO 24, 3 ECHO 7,2 ECHO 12 and each one of ECHO 3,11,14,15,27,32); 25 cases of Enterovirus ( 0.221 3 ,including 14 EV 70,11 EV 71);8 cases of Adenovirus ( 0.070 8 ,including 3 Adv 2,3 Adv 3 and 2 Adv 7). Results of different age groups indicated there was significant difference ( P < 0.05 ) in virus detection rate in two age groups. Virus positive rates in different years were 1990 1991 14.2 %(15/106),1992 1993 14.1 %(23/163),1994 1995 26.1 %(36/138),1996 1997 22.5 %(39/173),that showed a significant difference ( P < 0.05 ). Conclusion Virus infection rate of CNS diseases and FUO showed an a ascending trend,and the different virus types and kinds were isolated in different periods.